Objective To investigate the left ventricular function in patients with type 2 diabetes mellitus(DM) by tissue Doppler Tei index and quantitative tissue velocity imaging(QTVI). Methods 121 DM patients were divided into DM1 group(61 patients without microangiopathy) and DM2 group(60 patients with microangiopathy). Control group consisted of 50 normal subjects. Mitral peak flow velocity during early and late diastole (E, A), ratio of E/A obtained were detected by pulse Doppler imaging,the Tei index was obtained by pulse tissue Doppler imaging(TDI) and average peak velocities of six LV wall sites at mitral annuluses during systole, early and late diastole (MSm,Mem, Mam),and ratio of Mem/Mam obtained by QTVI were measured in all. Results MSm.Mem and Mem/Mam in DM1 and DM2 groups were significantly decreased,MSm(7. 13±1. 42) cm/s, (6. 49± 1. 29) cm/s vs (8.61±1.18) cm/s,Mem(6. 22±1. 39) cm/s, (4. 53±0. 94) cm/s vs (7. 91±1.15) cm/s and Mem/Mam 0. 79±0. 17,0. 59±0. 19 vs 1.03±0. 15(all P <0. 05). TDI-Tei index in DM1 and DM2 group was significantly higher compared with that of control group,0. 53±0. 09,0. 65±0. 08 vs 0. 44±0. 06(all P <0. 05). The TDI-Tei index was negatively correlated with E/A,Mem,Mem/Mam and MSm( r = -0. 363, -0. 551, -0. 533, -0. 614, all P <0. 01). Conclusion TDI-Tei index and QTVI-derived MSm, Mem, Mem/Mam are sensitive indexes to evaluate left ventricular dysfunction early. And functions decrease obviously in without microangiopathy group of type 2 DM. The damage degrees of left ventricular functions are more severe in type 2 DM with microangiopathy.%应用组织多普勒技术检测Tei指数及二尖瓣环舒缩速度,评价糖尿病(DM)患者左心室舒缩功能的变化.方法 2型DM患者121例,其中不伴微血管并发症者(DM1组)61例,伴微血管并发症者(DM2组)60例.健康对照组50例.脉冲多普勒测量二尖瓣口舒张早期血流速度(E)、舒张晚期血流速度(A),计算E/A值;脉冲组织多普勒测量左心功能Tei指数;定量组织多普勒技术测量左心室壁二尖瓣环6个位点(侧壁和后间隔、前壁和下壁、前间隔和后壁)处的收缩期峰值运动速度(Sm)、舒张早期峰值运动速度(Em)、舒张晚期峰值运动速度(Am),计算6个位点平均速度(MSm、Mem、Mam)及Mem/Mam值.结果 DM1组和DM2组MSm、Mem、Mem/Mam值较对照组显著减低,MSm(7.13±1.42)cm/s、(6.49±1.29)cm/s vs (8.61±1.18) cm/s,Mem(6.22±1.39) cm/s、(4.53±0.94)cm/s vs (7.91±1.15) cm/s,Mem/Mam值0.79±0.17、0.59±0.19 vs 1.03±0.15(均P＜0.05).DM1组和DM2组Tei指数较对照组显著增加,0.53±0.09、0.65±0.08 vs 0.44±0.06(均P＜0.05).DM组Tei指数与E/A值、Mem、Mem/Mam和MSm值呈显著负相关(r=-0.363、-0.551、-0.533、-0.614,均P＜0.01).结论 组织多普勒Tei指数与QTVI检测二尖瓣环舒缩速度能够敏感评价DM患者的左心功能障碍.这种功能障碍在DM无微血管并发症时即已发生,并随着微血管并发症的出现左心室舒缩功能进一步减低.
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